Table Of ContentMental Health Promotion in Schools:
Foundations
Edited By
Raymond J. Waller
Troy University
USA
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DEDICATION
To Jenny L. Nelson: friend, coworker, author, soundboard, and the
brains of the outfit, to Sarah, editor extraordinaire, to Emily for a reason
to and to laugh out loud in the process, and to appreciating entrapment
in Charlotte’s web.
CONTENTS
Foreword i
Preface v
List of Contributors ix
CHAPTERS
1. Mental Health Treatment or Promotion in Resource Allocation:
Two Topical Considerations Elucidate the Road Less Traveled 3
Raymond J. Waller, Carol L. Albertini and Nancy L. Kupfrian
2. Increasing School Attendance: The First Step in Promoting Mental
Health 28
Steven G. Little, Angeleque Akin-Little and Joshua Couperus
3. Student Engagement and Disengagement: An Intrinsic Motivation
Perspective and a Mental Health Concern 49
Howard Adelman and Linda Taylor
4. Teacher-Student Relationships in Mental Health Promotion 76
Melissa R. Dvorsky, Leslie K. Taylor and Mark D. Weist
5. Response to Intervention: A Proactive Approach Addressing a
Spectrum of Student Need 105
Allison Nealy
6. The Contribution of Extracurricular Activities to School Priorities
and Student Success 127
Aidyn L. Iachini and Dawn Anderson-Butcher
7. Positive Approaches to Behavior Management: Friend or Beast of
Burden for Professional Educators? 149
Kim Sheffield and Raymond J. Waller
8. Risk and Resilience in Middle Childhood: Lessons for School
Mental Health Promotion 165
Daisy R. Jackson and Elise Cappella
9. Culturally Responsive Education: Promoting the Mental Health of
All Students for Stronger, Inclusive Communities 204
JoEtta Gonzales
10. System of Care for Children with Severe Emotional Disturbance: A
Framework of Mental Health Promotion Based on Students Most
in Need 231
Denise M. Green and Sarah E. Twill
i
FOREWORD
I became involved in school mental health in 1991, right out of graduate school
and my pre-doctoral internship, with no prior background of working in schools.
My job was of an assistant professor in the Department of Psychiatry at the
University of Maryland, School of Medicine, and my assignment was to provide
mental health services at a large inner-city high school in Baltimore serving over
2000 students. Initially, I was overwhelmed by the assignment and honestly spent
some time being fairly confused on how to proceed. However, I immersed myself
in the work, and soon began to really like it. I also worked with some university-
based community mental health centers (CMHCs), and began to notice stark
differences between my work in them and my work in the schools. With
colleagues we came to a pretty straightforward, three point realization:
1. Children, adolescents and families were not getting to the CMHCs,
with many barriers (e.g., transportation, stigma, stress in families, lack
of knowledge of mental health or mental health services) getting in the
way, and even if a connection was made (after considerable burden
and a long waiting period), this was usually only for one or a very few
sessions,
2. The schools were overburdened with tremendous unmet mental health
needs of youth, and limited resources and staff to address mental
health needs, and
3. If we joined staff and programs from the CMHCs with staff and
programs from the schools, we could reach many more youth and we
would help both the mental health centers and the schools in achieving
their missions.
This realization, and increasing strong collaborative relations with a great group
of colleagues from multiple universities and youth serving systems in Baltimore
and the state of Maryland, helped our team to develop the expanded school mental
health (SMH) framework, involving a shared agenda (see Andis et al., 2002) of
schools, families, and community systems working together to develop and
ii
implement a full continuum of effective mental health promotion and intervention
for youth in general and special education (see Weist, 1997; Weist, Evans, &
Lever, 2003). In the early 1990s we explored dimensions of effective expanded
SMH in Baltimore, with an overriding emphasis on quality. By asking youth and
families, school, community, and government leaders what they wanted in quality
SMH, clear themes emerged of moving toward proactive, preventive and more
flexible mental health care, delivered by committed and caring professionals who
would eliminate bureaucratic barriers and work to rapidly provide help to youth in
need (Flaherty & Weist, 1999).
Immersion in this work led to an important opportunity to apply and receive
funding for one of two national centers for mental health in schools in 1995, with
initial funding from the Maternal and Child Health Bureau, which has continued
through 2010 to support the work of the University of Maryland, Center for
School Mental Health (CSMH; see http://csmh.umaryland.edu; www.school
mentalhealth.org). It has been a great privilege for me to participate in the
progressive development of the SMH field, and the CSMH, which has responded
to thousands of technical assistance requests, held 15 national conferences on
Advancing SMH, held 8 regional conferences on integrated school health and
mental health services (the School Health Interdisciplinary Program), developed
and widely disseminated over 150 documents and publications, and contributed to
significant collaboration at local, state, national, and international levels (see the
National Community on Collaborative School Behavioral Health,
www.sharedwork.org; the International Alliance for Child and Adolescent Mental
Health and Schools, www.intercamhs.org; the international journal, Advances in
School Mental Health Promotion, www.schoolmentalhealth.co.uk).
Mental health programs and services in school have been around for a long time
(see Sarason, 1996), but the norm has been for specific disciplines operating in
schools, often without a lot of interaction, and often with constraints on their
positions. Citing two examples, in spite of the fact that many have training as
mental health professionals, school psychologists and counselors are often
constrained into roles emphasizing evaluation and academic advisement
(respectively), training and support for these staff members are often limited, and
ratios of these staff members to students are far below those recommended by
iii
professional associations (see Flaherty et al., 1998; DuPaul, 2007; Weist et al.,
2007). In contrast, the SMH field emerging and gaining strength in the last two
decades emphasizes on an interdisciplinary and inter-systems (e.g., education,
mental health, child welfare, juvenile services) approach that is actively guided by
youth and families, and other key stakeholders such as teachers and community
leaders (see Lever et al., 2003). While the research literature is still developing,
advantages for SMH are being documented, including improving access to care
(Burns et al., 1995; Catron, Harris, & Weiss, 1998; Rones & Hoagwood, 2000),
enhancing preventive services (Elias, Gager, & Leon, 1997; Weare, 2000),
increasing early problem identification (Weist, Myers, Hastings, Ghuman, & Han,
1999), decreasing stigma (Atkins, Adil, Jackson, McKay, & Bell, 2001; Nabors &
Reynolds, 2000), and increasing generalization of intervention impacts across
settings (Evans, Langberg, & Williams, 2003).
The federal government in the United States is providing significant support to the
SMH field (see Anglin, 2003) through major policy reports, including Surgeon
General’s reports on transforming mental health and children’s mental health
services (U.S. Department of Health and Human Services, 1999; U.S. Public
Health Service, 2000) and the Achieving the Promise Report (President’s New
Freedom Commission, 2003), which emphasized SMH services as one of 19
prioritized recommendations (recommendation 4.2). There are also many federal
grants supporting SMH, including those focused on Systems of Care (led by the
Substance Abuse and Mental Health Services Administration [SAMHSA]), Safe
Schools/Healthy Students (led by the U.S. Department of Education [DOE] and
SAMHSA), Mental Health Integration into the Schools (led by DOE), Capacity
Building for SMH (led by the Centers for Disease Control and Prevention), and
strong support for SMH research from the National Institute of Mental Health,
and the Institute for Education Sciences.
Indeed, in the U.S., school mental health programs and services are showing
progressive growth, even in these economically challenging times. However, in
spite of this progress, there is much to be done, in building the research base; and
increasing implementation support for high quality, evidence-based practices (see
Evans & Weist, 2004; Fixsen et al., 2005; Weist et al., 2009); broadening training
opportunities at pre-service and in-service levels, especially effective
iv
interdisciplinary training that embraces principles of adult learning (Mellin,
2009); building policy support for SMH (Weist et al., 2007); and increasing
connections among training, practice, research and policy realms (Paternite,
Weist, Burke, & Flaspohler, 2008). There is also a critical social marketing
agenda to pursue increasing public awareness and involvement in the SMH
agenda, supporting work that promotes students’ wellness, reduces academic and
non-academic barriers to their learning, and increases the likelihood of academic
and subsequent career success.
To promote progress in all of the above there is a need to broaden the knowledge
base in the field and to promote collaboration among the diverse stakeholders who
have a vested interest in improving and expanding SMH (see President’s New
Freedom Commission, 2003). To that end, I am very pleased to provide the
introduction of this book published by Bentham Science, and edited by leader in
the field, Raymond J. Waller. This book, the first in a series and focused on
Foundations, will be an important resource in the compelling school mental health
field.
Mark D. Weist
University of South Carolina
USA
